AccountId: 011433970860
ContactId: 08727224-c0f7-48d7-97ef-f69cb7b13d53
Channel: VOICE
LanguageCode: en-US
Total Conversation Duration: 298140 ms
Total Talk Time (AGENT): 88448 ms
Total Talk Time (CUSTOMER): 133475 ms
Interruptions: 0
Overall Sentiment: AGENT=0.4, CUSTOMER=0
Redaction Types: PII
Input Audio S3: s3://apl-connect-contactcenter-data-prod/connect/apl-prod/CallRecordings/2025/04/15/08727224-c0f7-48d7-97ef-f69cb7b13d53_20250415T21:23_UTC.wav
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[AGENT][POSITIVE] Good afternoon. Thank you for calling APL. My name is [PII]. How may I help you?
[CUSTOMER][NEUTRAL] Hi [PII], my name is [PII] and I'm with Baptist Health Medical Group, and I was calling to get claim status or help with the claim.
[AGENT][NEUTRAL] OK, well, I can definitely help you with the claim status. And [PII], may I have a good contact number in case we're disconnected and then the member's policy number?
[CUSTOMER][NEUTRAL] OK, my number is [PII].
[CUSTOMER][NEUTRAL] And the policy number is 1480429ML7.
[AGENT][NEUTRAL] Thank you for that. And can you verify the member's first and last name and date of birth?
[CUSTOMER][NEUTRAL] Yes, it's [PII] [PII].
[AGENT][NEUTRAL] Thank you, and all the information provided is a verification of benefits, not a guarantee of payment. And may I have the date of service for the claim and the total bills?
[CUSTOMER][NEUTRAL] Yes, it's for [PII] we billed $159.
[AGENT][NEUTRAL] Thank you, hold on one moment.
[AGENT][NEUTRAL] Alright, so I just located the claim. I'm waiting for it to come up now. Hold on one moment.
[AGENT][NEUTRAL] Alright, so we received the claim on [PII].
[AGENT][NEUTRAL] The claim number is 356-063-1.
[AGENT][NEUTRAL] And on [PII], the claim was denied because the inpatient benefit for the calendar year has been met.
[CUSTOMER][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] And I don't know I don't I don't understand what I'm doing as far as your website goes, but I can never seem to find any claims.
[CUSTOMER][NEUTRAL] For this gentleman, OK, so I'm gonna try putting in that claim number 356-063-1.
[AGENT][NEUTRAL] There's a patient account number also if you need it.
[CUSTOMER][NEUTRAL] I don't know.
[CUSTOMER][NEUTRAL] I don't know, um.
[CUSTOMER][NEUTRAL] Well, what's the date of birth?
[CUSTOMER][NEGATIVE] Because I try utilizing portals before I call, but now it says claims.
[AGENT][NEUTRAL] Mhm.
[CUSTOMER][NEGATIVE] Oh it's searching now. I don't know it pulled it up. I tried doing just a search by uh because it says don't have an APL claim number and I put all that information in but it didn't pull up anything.
[AGENT][NEUTRAL] Mhm.
[AGENT][NEUTRAL] Oh, what information did they ask for?
[AGENT][NEUTRAL] Like this
[CUSTOMER][NEUTRAL] OK. So as for the patient's name.
[AGENT][NEUTRAL] Oh, OK, OK.
[CUSTOMER][NEUTRAL] The date of birth, the last four of his social, patient account number, and then the date of service, um.
[CUSTOMER][NEUTRAL] So let's see.
[CUSTOMER][NEUTRAL] What was my date to service [PII]. OK, I see that.
[CUSTOMER][NEGATIVE] I'm trying to see uh I click on it and nothing happens.
[CUSTOMER][NEUTRAL] I was trying to see if I could get an EOB from your portal so that we can actually post.
[CUSTOMER][NEUTRAL] Um, because I don't have an EOB in that.
[CUSTOMER][NEUTRAL] That process back in February you said yeah, [PII].
[AGENT][NEUTRAL] Yes, ma'am. Um, if it, do you see like the
[AGENT][NEUTRAL] Where the claim, where the claim popped up, it should be like a downloadable link.
[CUSTOMER][NEUTRAL] Yeah, I'm waiting for it. It's spinning, but hold on, I think something might have happened just now.
[AGENT][NEUTRAL] OK.
[CUSTOMER][NEUTRAL] This is not a bill. OK, I think it pulled up finally, yeah, OK.
[AGENT][NEUTRAL] Got it. OK.
[CUSTOMER][NEUTRAL] Yeah, I am so sorry and I like I said it wouldn't the claim would not pull up with the search that I did.
[AGENT][NEUTRAL] Oh, you are fine.
[AGENT][NEUTRAL] That's what we're here for. You just needed to talk to me today, that's all.
[CUSTOMER][NEUTRAL] All right.
[CUSTOMER][POSITIVE] Apparently so. Well, I thank you so much for your help. Um, do you have reference numbers for your call?
[AGENT][NEUTRAL] Um, so there's no call reference number, but you can use my name in today's date. The first initial to my last name is [PII].
[CUSTOMER][POSITIVE] All right thank you so much have a good day.
[AGENT][NEUTRAL] You're welcome, [PII]. Was there anything else I can help with?
[CUSTOMER][NEUTRAL] No, that was all.
[AGENT][POSITIVE] Alright, thanks for calling APL have a great day.
[AGENT][NEUTRAL] Bye bye.
[CUSTOMER][POSITIVE] You too. Thanks. Goodbye.